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Be Safe Educational articles cover the medical industry, as well as our emergency medical equipment product and distribution.

Pre-Hospital Emergency Vehicle and Equipment Hygiene

Pre-Hospital Emergency Vehicle and Equipment Hygiene

The issue of ambulance/ pre-hospital emergency vehicle hygiene is by no means a new one. When perusing through a number of articles and papers, it is quite clear that it is an issue of concern in both first world and developing countries alike. In several reports, indications are that emergency services (EMS) worldwide are putting vulnerable patients at risk by exposing them to a catalogue of hygiene problems before they have even reached the hospital.

Pelvic Structures and Emergency Care

Pelvic Fractures and Emergency Care

Pelvic fractures can occur after both low-energy and high-energy traumatic events. Low-energy pelvic fractures occur most frequently in adolescents and the elderly. In Adolescents, injuries are typically associated with sports related activities. Low-energy pelvic fractures in the elderly frequently result from falls, which most often present as stable fractures of the pelvic ring.

Turning up the Heat on Burns

Turning up the Heat on Burns

Burns remain a significant cause of death in both adult and paediatric patients in South Africa. Globally, it is estimated that an average of 300 000 people die yearly from fire related injuries alone. Burns in children are reported to be amongst the most prevalent traumatic injuries around the world. In low income countries, and vulnerable populations, burn injuries are reported to be the third most common cause of death in children aged 5 to 14 years, with road traffic injuries and drowning being first and second respectively

Pulse Oximeter – The Basics

There is no doubt that pulse Oximeter plays a crucial part in patient monitoring, however it must be said that one should not use it without considering important factors such as, patient medical history, clinical examination findings and if there are any other factors that could influence the readings presented by the pulse Oximeter. In this article, I would like to focus on the basics of pulse Oximeter and some of the pros and cons associated with its use.

Pharmacology 101 (Part 1) – The Basics

Recently I have been receiving many questions on some very basic concepts and terminology related to pharmacology. Given the expansive distribution of The Responder articles, I thought it would be a good idea to put pen to paper and do a basic overview of what it’s all about. This article will run in two parts. Watch out for part 2 in the next edition of The Responder. These articles may be of particular value to all those who currently hold basic life support qualifications and have thus not necessarily received introductory training in pharmacology. So let’s get going…

Pharmacology 101 (Part 2) – The Basics

Pharmacology 101 (Part 3) – The Grand Finale

In the previous two editions we discussed the basics of pharmacology and pharmacokinetics which included the processes of absorption, distribution, metabolism and excretion. In this edition we will focus on the pharmacodynamic phase of pharmacology, which in essence relates to the study of how a drug acts on the body.

Emergency Care Skills – Needle Cricothyroidotomy

Airway management and effective oxygenation is a priority in the resuscitation of the critically ill or injured patient In general, airway management can be achieved by either basic or advanced airway manoeuvres. Basic airway manoeuvres are widely taught and are as simple as performing a head-tilt-chin-lift or jaw-thrust to relieve obstruction by the tongue.

Emergency Care Skills – Surgical Cricothyroidotomy

Emergency surgical cricothyroidotomy is an emergency procedure involving incising or puncturing the cricothyroid membrane and passing a cuffed endotracheal tube through the incision into the trachea for ventilation purposes. It can be achieved relatively easily, however, as with all other pre-hospital skills, it requires regular practise. As part of your on-going medical education, you should be making regular visits to your in-service educational department, where there should be an abundance of training equipment for you to practise this skill.

JumpBags – Whats the Big Deal?

For those of you who have worked out of a jumpbag at the scene of any medical emergency (and I imagine that’s many of you), you will know that your jumpbag is potentially your patient’s lifeline. Yes I agree that the thinking behind the use of the equipment in your jumpbag is equally important. I remember a legend of a professor telling me that it’s not the cost of the stethoscope that matters, but rather what is found in-between the earpieces… too true Prof…

Open Pneumothorax – Recognition, Treatment and Complications

Open pneumothorax (or sucking chest wound) can be devastating when not recognised and treated appropriately. The chest cavity needs to be intact in order for ventilation to be effective. As such, standard field care focusses on sealing the chest wound with an occlusive dressing.

This article is aimed at the basics (as I have been accused of sometimes providing too much depth to our articles), because in essence, the basics is what saves lives… Agree? I say this based on experience and not through knowledge gained from textbooks.

Tension Pneumothorax- Pathophysiology and Emergency Care

Tension pneumothorax is the progressive build-up of air within the pleural space, usually due to a lung laceration which allows air to escape into the pleural space but not move out. As more air leaks out filling the pleural space with each breath, the patient will find it progressively more difficult to breathe. As emergency care providers become aware of the respiratory distress and decreased ability to expand the chest, the obvious choice would be to initiate positive pressure ventilation. Unfortunately, Positive pressure ventilation may exacerbate the rate of pleural space filling. Progressive build-up of pressure in the pleural space pushes the mediastinum in the opposite direction to the injured lung, and obstructs venous return to the heart. This ultimately leads to circulatory instability and may result in traumatic cardiac arrest.

Let’s get down and Bougie…

I know I am probably sticking my foot in it by making this statement; however for those of you who know me on a personal level, you will know that I am pretty straight forward and upfront, so I am going to say it anyway… Attitude is everything when it comes to practising Para medicine. Unfortunately, in my 20 odd years working as a paramedic, I have come across some hectic egos. Have you ever heard a paramedic say, “I never use an introducer or bougie to intubate patients” (indirectly what they are really saying is…I am just that good).

Well now… let me tell you what I have seen in South Africa and several other countries… I have seen paramedics adopt the attitude of “that tube is going in come hell or high water”. They approach difficult intubations much the same way as straight forward and uncomplicated intubations (much to the detriment of the patient) and still, no introducer or bougie in sight. It’s all about attitude.

To Tourniquet or not to Tourniquet… That is the question?

Is it not amazing how certain treatments fall in favour, then out and then back in again? I imagine that when most of us were trained you were taught to err on the side of omission when it came to applying a tourniquet. Effectively, patients would need to be banging on the doors at the Pearly Gates before someone would say, “Hmmm maybe we should try a tourniquet…”

So why were we so jumpy when it came to the application of tourniquets in the good ‘ol days? Well from personal experience in my early days as an emergency care provider (which was in the late 80’s), I remember my instructor telling me. “Your patient will lose his/her limb”. I remember asking, “Wouldn’t it be better to lose a limb than almost your entire blood volume and then your life?”

The IFAK (Individual First Aid Kit) – Easy Steps to Saving a Life

The IFAK concept seems to be slowly but surely making a presence in South Africa. As a health care professional, it certainly is not where I believe it should be, given the number of public services (excluding EMS and Fire Services) out there that have the potential to come into direct contact with either an injured colleague or member of the public. I thought that by perhaps writing a “shortish” (although I am regularly accused of speaking too much) article and providing a bit of insight into the concept of IFAK, we may see these kits reach the most important audience, where ultimately they could save so many more lives… The services I am speaking about in general are our Police Services, Traffic Services or any other public (or private) law enforcement agency that may be exposed to an injured person. So let’s dive right in…